中华肝脏病杂志
中華肝髒病雜誌
중화간장병잡지
CHINESE JOURNAL OF HEPATOLOGY
2013年
8期
599-603
,共5页
张大鹍%陈敏%刘阳%王瑞芳%董晓宇%李志艳%周光德
張大鹍%陳敏%劉暘%王瑞芳%董曉宇%李誌豔%週光德
장대곤%진민%류양%왕서방%동효우%리지염%주광덕
肝硬化%诊断%肝炎,丙型,慢性%声辐射力脉冲成像%实时超声弹性成像
肝硬化%診斷%肝炎,丙型,慢性%聲輻射力脈遲成像%實時超聲彈性成像
간경화%진단%간염,병형,만성%성복사력맥충성상%실시초성탄성성상
Liver cirrhosis%Diagnosis%Hepatitis C,chronic%Acoustic radiation force impulse%Real-time ultrasonic elastography
目的 探讨声脉冲辐射力成像技术(ARFI)在评价慢性丙型肝炎肝纤维化程度上的临床价值. 方法 对108例慢性丙型肝炎患者应用ARFI技术对肝脏的实时超声弹性进行测量,患者均进行肝活组织检查,以病理检查结果与肝脏的实时超声弹性测值进行比较,计算ARFI技术诊断肝纤维化的灵敏度,特异度,取敏感度和特异度之和最大时为最佳界限值.应用SPSS10.0统计学软件进行统计学处理,多组间比较根据数据是否正态分布及方差齐性来选择采用参数或非参数检验分析,相关性分析采用spearman相关分析. 结果 慢性丙型肝炎患者肝纤维化分期S1 ～ S4期的ARFI平均值分别为(1.26±0.27) m/s(n=36)、(1.45±0.51) m/s(n=31)、(2.01±0.54)m/s(n=27)和(2.28±0.82) m/s(n=14),组间比较,秩和检验KW=42.307,P＜0.01.肝脏ARFI测值与肝纤维化分期相关,相关系数为0.61,P＜0.01.ARFI技术诊断慢性丙型肝炎肝纤维化S≥2,S≥3和S=4的受试者工作特征曲线下面积分别为0.779,0.863和0.880.结论 ARFI可较准确的定量评价慢性丙型肝炎肝纤维化程度,具有良好的临床应用前景.
目的 探討聲脈遲輻射力成像技術(ARFI)在評價慢性丙型肝炎肝纖維化程度上的臨床價值. 方法 對108例慢性丙型肝炎患者應用ARFI技術對肝髒的實時超聲彈性進行測量,患者均進行肝活組織檢查,以病理檢查結果與肝髒的實時超聲彈性測值進行比較,計算ARFI技術診斷肝纖維化的靈敏度,特異度,取敏感度和特異度之和最大時為最佳界限值.應用SPSS10.0統計學軟件進行統計學處理,多組間比較根據數據是否正態分佈及方差齊性來選擇採用參數或非參數檢驗分析,相關性分析採用spearman相關分析. 結果 慢性丙型肝炎患者肝纖維化分期S1 ～ S4期的ARFI平均值分彆為(1.26±0.27) m/s(n=36)、(1.45±0.51) m/s(n=31)、(2.01±0.54)m/s(n=27)和(2.28±0.82) m/s(n=14),組間比較,秩和檢驗KW=42.307,P＜0.01.肝髒ARFI測值與肝纖維化分期相關,相關繫數為0.61,P＜0.01.ARFI技術診斷慢性丙型肝炎肝纖維化S≥2,S≥3和S=4的受試者工作特徵麯線下麵積分彆為0.779,0.863和0.880.結論 ARFI可較準確的定量評價慢性丙型肝炎肝纖維化程度,具有良好的臨床應用前景.
목적 탐토성맥충복사력성상기술(ARFI)재평개만성병형간염간섬유화정도상적림상개치. 방법 대108례만성병형간염환자응용ARFI기술대간장적실시초성탄성진행측량,환자균진행간활조직검사,이병리검사결과여간장적실시초성탄성측치진행비교,계산ARFI기술진단간섬유화적령민도,특이도,취민감도화특이도지화최대시위최가계한치.응용SPSS10.0통계학연건진행통계학처리,다조간비교근거수거시부정태분포급방차제성래선택채용삼수혹비삼수검험분석,상관성분석채용spearman상관분석. 결과 만성병형간염환자간섬유화분기S1 ～ S4기적ARFI평균치분별위(1.26±0.27) m/s(n=36)、(1.45±0.51) m/s(n=31)、(2.01±0.54)m/s(n=27)화(2.28±0.82) m/s(n=14),조간비교,질화검험KW=42.307,P＜0.01.간장ARFI측치여간섬유화분기상관,상관계수위0.61,P＜0.01.ARFI기술진단만성병형간염간섬유화S≥2,S≥3화S=4적수시자공작특정곡선하면적분별위0.779,0.863화0.880.결론 ARFI가교준학적정량평개만성병형간염간섬유화정도,구유량호적림상응용전경.
Objective To investigate the diagnostic value of acoustic radiation force impulse (ARFI)imaging technology for the assessment of liver fibrosis in chronic hepatitis C (CHC) patients.Methods One-hundred-and-eight CHC patients were examined by real-time ultrasound elastography using the Acuson S2000 ARFI instrument (Siemens Healthcare) and underwent liver biopsy for pathohistological analysis.The correlation between liver fibrosis grades determined by the two approaches was analyzed.The cut-off values for diagnosis by ARFI (S ＞ 2,S ＞ 3 and S =4) were determined by generating a receiver operating characteristic (ROC) curve.Results The spectrum of liver stiffness detected by ARFI sonoelastography included S1 at (1.26 ± 0.27) m/s (n =36),S2 at (1.45 ± 0.51) m/s (n =31),S3 at (2.01 ± 0.54) m/s (n =27),and S4 at (2.28 ± 0.82) m/s (n =14).The ARFI values were significantly different among the four different stages of liver fibrosis (P ＜ 0.001).The liver stiffness detected by ARFI sonoelastography was significantly correlated with the liver fibrosis stage determined by the gold standard pathohistological analysis (Spearman's rank coefficient:0.61,P ＜ 0.001).Using the ARFI technology for assessment of liver fibrosis gave areas under the ROC curve of 0.779 for S ＞ 2 patients,of 0.863 for S ＞ 3 patients,and of 0.0880 for S =4 patients.Conclusion The real-time ultrasound elastographic ARFI teehnology can show the elasticity modulus of liver,and its data values positively correlate with the patho-histology grade of liver fibrosis in CHC patients.ARFI technology is easy to operate,non-invasive,and quantitative,and has potential clinical value for assessing liver fibrosis in CHC.
